Myasthenia gravis (MG) is an acquired autoimmune disease affecting synaptic transmission via the neuromuscular junction mainly due to the presence of auto-antibodies targeting acetylcholine receptors. Ocular or generalized MG is clinically diagnosed when the extra-ocular muscles or other muscle... Read more

Myasthenia gravis (MG) is an acquired autoimmune disease affecting synaptic transmission via the neuromuscular junction mainly due to the presence of auto-antibodies targeting acetylcholine receptors. Ocular or generalized MG is clinically diagnosed when the extra-ocular muscles or other muscle groups beyond the extra-ocular muscles are involved. MG occurs in both sexes at any ages from all races but shows a wide variability in incidence and prevalence. Differences in clinical phenotypes of MG patients between West and East countries have been observed. Herein, we review the current concept on epidemiology, classification, and generalized progression in MG, mainly focusing on the differential features from mainland China. Back

Aim: To test the hypothesis that lymphocyte infiltration in brain arteriovenous malformation (bAVM) is not associated with iron deposition (indicator of micro-hemorrhage). Methods: Sections of unruptured, previously untreated bAVM specimens (n = 19) were stained immunohistochemically for T-lymphocytes (CD3+), B-lymphocytes (CD20+), plasma cells (CD138+) and macrophages (CD68+). Iron deposition was assessed by hematoxylin and eosin and Prussian blue stains. Superficial temporal arteries (STA) were used as control. Results: Both T‑lymphocytes and macrophages were present in unruptured, previously untreated bAVM specimens, whereas few B cells and plasma cells were detected. Iron deposition was detected in 8 specimens (42%; 95% confidence intervals = 20-67%). The samples with iron deposition tended to have more macrophages than those without (666 ± 313 vs. 478 ± 174 cells/mm2; P = 0.11). T‑cells were clustered on the luminal side of the endothelial surface, on the vessel‑wall, and in the perivascular regions. There was no correlation between T‑lymphocyte load and iron deposition (P = 0.88). No macrophages and lymphocytes were detected in STA controls. Conclusion: T‑lymphocytes were present in bAVM specimens. Unlike macrophages, the load and location of T‑lymphocytes were not associated with iron deposition, suggesting the possibility of an independent cell‑mediated immunological mechanism in bAVM pathogenesis. Back

Parkinson's disease (PD) is a prevalent neurodegenerative disorder mainly affecting the population over the age of 60 years. The past decade has seen rapidly emerging data supporting a major importance of genetic factors in the development of PD. Increasing number of large-scale and replicating... Read more

Parkinson's disease (PD) is a prevalent neurodegenerative disorder mainly affecting the population over the age of 60 years. The past decade has seen rapidly emerging data supporting a major importance of genetic factors in the development of PD. Increasing number of large-scale and replicating association studies has facilitated the confirmation of the possible predisposing factors to PD and the selection of genetic variants for risk prediction. While evidences are accumulating that variations within the SNCA, LRRK2, MAPT and GBA genes increase the individuals' vulnerability to PD, inconclusive or negative results have been reported for an association between PD and variants of the parkin, PINK1, DJ-1, UCH-L1, Omi/HtrA2, GIGYF2, PLA2G6, VPS35, EIF4G1 and BST1 genes. However, our understanding of the genetic picture of PD remains preliminary. Molecular diagnosis of the disease is only recommended for cases with clear family history, and currently, there is no ideal genomic biomarker available to predict the disease onset and progression, or to make a molecular classification of the disease. Efforts are expected to identify more genetic predisposing factors and to further clarify their roles in the mechanisms of PD. Back

Aim: During the past decade, there has been an increasing interest in the evaluation of cognitive function in myasthenia gravis (MG), neuromuscular transmission disorder caused by acetylcholine receptor auto-antibodies. However, the results of previous studies on cognition and MG are inconsistent... Read more

Aim: During the past decade, there has been an increasing interest in the evaluation of cognitive function in myasthenia gravis (MG), neuromuscular transmission disorder caused by acetylcholine receptor auto-antibodies. However, the results of previous studies on cognition and MG are inconsistent and controversial. This study aimed to evaluate cognition in patients with mild/moderate grades of MG. Methods: This study included 20 patients with MG with a mean age of 28.45 ± 8.89 years and duration of illness of 3.52 ± 1.15 years. Cognition was tested using a sensitive battery of psychometric testing (Mini‑mental State Examination [MMSE], Stanford-Binet Intelligence Scale 4th edition [SBIS] and Wechsler Memory Scale‑Revised [WMS‑R]) and by recording P300 component of event‑related potentials (ERPs), a neurophysiological analog for cognitive function. Results: Compared with healthy subjects (n = 20), patients had lower total scores of cognitive testing (MMSE, SBIS and WMS‑R) (P = 0.001), higher Beck Depression Inventory 2nd edition scores (P = 0.0001) and prolonged latencies (P = 0.01) and reduced amplitudes (P = 0.001) of P300 component of ERPs. Correlations were identified between total scores of cognitive testing and age (r = -0.470, P = 0.010), duration of illness (r = -0.788, P = 0.001) and depression scores (r = -0.323, P = 0.045). Using linear regression analysis and after controlling for age and depression scores, a significant correlation was identified between total scores of cognitive testing and duration of illness (β = -0.305, P = 0.045). Conclusion: Patients with mild/moderate MG may have cognitive dysfunction. This is important to determine prognosis and managing patients. Back

Glioma, the most frequent primary brain tumor in adults, is a highly infiltrative tumor exhibiting resistance to most treatments and associated with short survival of patients. Positron emission tomography (PET) imaging using various tracers takes advantage of the increased metabolic rate of... Read more

Glioma, the most frequent primary brain tumor in adults, is a highly infiltrative tumor exhibiting resistance to most treatments and associated with short survival of patients. Positron emission tomography (PET) imaging using various tracers takes advantage of the increased metabolic rate of neoplastic cells, in order to detect tumors and validate the treatment response. The most frequently used PET tracer, the (18)F-fluorodeoxyglucose (FDG), is useful during the initial and follow-up assessment of patients with gliomas because it can assist in the selection of the initial biopsy site and to assess early response to a given therapeutic intervention. Furthermore, when there is tumor re-growth after an initial remission, FDG-PET can differentiate between true tumor recurrence versus necrosis from radiation therapy. Newly developed PET tracers may exhibit better sensitivity than FDG to diagnose primary brain tumors, but may occasionally produce false positive results in various conditions. In any event, PET is a useful tool in patients with central nervous system cancer during both initial assessment and follow-up. Back

Aim: The cytokine receptor tumor necrosis factor receptor superfamily member 9 (TNFRSF9) is mainly considered to be a co-stimulatory activation marker in hematopoietic cells. Several preclinical models have shown a dramatic beneficial effect of treatment approaches targeting TNFRSF9 with... Read more

Aim: The cytokine receptor tumor necrosis factor receptor superfamily member 9 (TNFRSF9) is mainly considered to be a co-stimulatory activation marker in hematopoietic cells. Several preclinical models have shown a dramatic beneficial effect of treatment approaches targeting TNFRSF9 with agonistic antibodies. However, preliminary clinical phase I/II studies were stopped after the occurrence of several severe deleterious side effects. In a previous study, it was demonstrated that TNFRSF9 was strongly expressed by reactive astrocytes in primary central nervous system (CNS) tumors, but was largely absent from tumor or inflammatory cells. The aim of the present study was to address the cellular source of TNFRSF9 expression in the setting of human melanoma brain metastasis, a highly immunogenic tumor with a prominent tropism to the CNS. Methods: Melanoma brain metastasis was analyzed in a cohort of 78 patients by immunohistochemistry for TNFRSF9 and its expression was correlated with clinicopathological parameters including sex, age, survival, tumor size, number of tumor spots, and BRAF V600E expression status. Results: Tumor necrosis factor receptor superfamily member 9 was frequently expressed independently on both melanoma and endothelial cells. In addition, TNFRSF9 was also present on smooth muscle cells of larger vessels and on a subset of lymphomonocytic tumor infiltrates. No association between TNFRSF9 expression and patient survival or other clinicopathological parameters was seen. Of note, several cases showed a gradual increase in TNFRSF9 expression on tumor cells with increasing distance from blood vessels, an observation that might be linked to hypoxia‑driven TNFRSF9 expression in tumor cells. Conclusion: The findings indicate that the cellular source of TNFRSF9 in melanoma brain metastasis largely exceeds the lymphomonocytic pool, and therefore further careful (re‑) assessment of potential TNFRSF9 functions in cell types other than hematopoietic cells is needed. Furthermore, the hypothesis of hypoxia‑driven TNFRSF9 expression in brain metastasis melanoma cells requires further functional testing. Back

Multifocal motor neuropathy (MMN) is the one of the most common acquired immune-mediated inflammatory disorders of the peripheral nervous system. The diagnosis is based on the distribution pattern of the neurological semiology and the pathological changes of nerve conduction studies (NCS) in... Read more

Multifocal motor neuropathy (MMN) is the one of the most common acquired immune-mediated inflammatory disorders of the peripheral nervous system. The diagnosis is based on the distribution pattern of the neurological semiology and the pathological changes of nerve conduction studies (NCS) in classical cases. However, in cases with subtle clinical presentation, an extended diagnostic workup may be needed, such as cerebrospinal fluid examination, laboratory tests, and nerve biopsy. NCS remain nowadays fundamental not only for the diagnosis, but also for the follow-up and measurement of response to immune-treatment in MMN. New challenges arose though, on how best to acquire a static and dynamic imaging of the peripheral nerves, aiming to provide a holistic approach to the nerve impairment. According to the literature, neuromuscular ultrasound is able to detect in MMN patients thickened or swollen cervical roots, peripheral nerves or brachial plexus, findings that suggest ongoing inflammation. This review provides a timely update on the nerve ultrasound findings in MMN. Back

Aim: The neutrophil-to-lymphocyte ratio (NLR) has prognostic value in patients with a variety of cancers. The purpose of this study was to investigate the prognostic value of NLR in patients with glioblastoma. Methods: A prospective study was conducted on patients receiving surgery for... Read more

Aim: The neutrophil-to-lymphocyte ratio (NLR) has prognostic value in patients with a variety of cancers. The purpose of this study was to investigate the prognostic value of NLR in patients with glioblastoma. Methods: A prospective study was conducted on patients receiving surgery for glioblastoma. Preoperative NLR was recorded and correlated with other prognostic factors and survival. Results: Fifty‑one patients were included in the study. The mean NLR ratio was 6.7 ± 4.6. Using receiver operating characteristic curve analysis, an NLR cut‑off value of 4.7 was determined to best predict survival. Patients with NLR ratios exceeding 4.7 differed significantly from those with NLR ratios ≤ 4.7 and were associated with reduced survival. Patients with gross total tumor excision had a median survival of 18 months, whereas the median survival time was 11 months in patients with subtotal tumor excision. No significant difference in survival was observed with respect to patient age, gender, Karnofsky performance status, or tumor location. Using multivariate analysis, NLR and extent of tumor resection were identified as factors with independent prognostic power. Conclusion: Neutrophil‑to‑lymphocyte ratio is an inexpensive, widely available biomarker of glioblastoma aggressiveness and should be used alongside current glioblastoma prognostic factors. Back

Non-albicans candida meningitis is a relatively rare disease, with nonspecific clinical manifestation, which makes the misdiagnosis occur sometimes, especially in the early stage of the disease. Abuse of broad-spectrum antibiotics, corticosteroids, central vein cannulas, senility, big operation,... Read more

Non-albicans candida meningitis is a relatively rare disease, with nonspecific clinical manifestation, which makes the misdiagnosis occur sometimes, especially in the early stage of the disease. Abuse of broad-spectrum antibiotics, corticosteroids, central vein cannulas, senility, big operation, malignancy, and total parenteral alimentation were all the susceptible factors of non-albicans candida infection. We present a case of this type of non-albicans infection in a 42-year-old woman who was early misdiagnosed as tuberculous meningitis and was treated with antibiotics and antituberculosis agents. The diagnosis of non‑albicans infection was confirmed by fungus culture of the cerebrospinal fluid (CSF) with a low detectable rate. This case reminds us that the non‑albicans candida meningitis had a nonspecific clinical presentations and laboratory data, and was difficult to differentiate from tuberculosis meningitis. Hence, we should highly suspect this disease if central nervous system infections with uncertain pathogens. Test cell counts; protein and fungus culture of CSF should be used to confirm the diagnosis. Once the diagnosis was established, the patients should receive antifungal treatment based on drug sensitivity tests as early as possible. Back

This review examines glioma disease initiation, promotion, and progression with a focus on the cell types present within the tumor mass and the molecules responsible for the immunosuppressive microenvironment that are present at each step of the disease. The cell types and molecules present also... Read more

This review examines glioma disease initiation, promotion, and progression with a focus on the cell types present within the tumor mass and the molecules responsible for the immunosuppressive microenvironment that are present at each step of the disease. The cell types and molecules present also correlate with the grade of malignancy. An overall "type 2" chronic inflammatory microenvironment develops that facilitates glioma promotion and contributes to the neo-vascularization characteristic of gliomas. An immunosuppressive microenvironment shields the tumor mass from clearance by the patient's own immune system. Here, we provide suggestions to deal with a chronically-inflamed tumor microenvironment and provide recommendations to help optimize adjuvant immune- and gene therapies currently offered to glioma patients. Back

Primary non-Hodgkin lymphoma of the cranial vault with extra and intracranial extension in a nonimmunocompromised patient is extremely uncommon. Until date, only limited number of such cases has been reported in the literature and none was the lesion located as a diffuse swelling in the forehead.... Read more

Primary non-Hodgkin lymphoma of the cranial vault with extra and intracranial extension in a nonimmunocompromised patient is extremely uncommon. Until date, only limited number of such cases has been reported in the literature and none was the lesion located as a diffuse swelling in the forehead. Imaging of the present case showed in a homogenous contrast enhancement mass involving the scalp of bifrontal supraorbital compartment and intracranial extra axial extension through the frontal bone with extension to the right orbit and right ethmoidal sinus. The intracranial mass was excised along with involved dura. Histopathology of the mass showed diffuse large B-cell non-Hodgkin lymphoma. Back

Pyroptosis is a new process of programmed cell death, which has been discovered and confirmed in recent years. Its cardinal features include activation of caspase-1 and a massive release of inflammatory cytokines (interleukin (IL)-1β, IL-18), etc. The morphological characteristics, occurrence and... Read more

Pyroptosis is a new process of programmed cell death, which has been discovered and confirmed in recent years. Its cardinal features include activation of caspase-1 and a massive release of inflammatory cytokines (interleukin (IL)-1β, IL-18), etc. The morphological characteristics, occurrence and regulatory mechanisms of the pyroptosis greatly, differ from other cell death mechanisms such as apoptosis and necrosis. It has already been proven that pyroptosis participates and plays an important role in a wide range of neuronal diseases. Here, we review the current understanding of the pyroptosis and its roles in neurological diseases. Back

Intracranial large vessel involvement is an unusual complication of tuberculous meningitis. The authors report a 39-year-old female presenting with an episode of seizure, followed by rapid decline in sensorium without prominent systemic features. An initial cranial magnetic resonance imaging... Read more

Intracranial large vessel involvement is an unusual complication of tuberculous meningitis. The authors report a 39-year-old female presenting with an episode of seizure, followed by rapid decline in sensorium without prominent systemic features. An initial cranial magnetic resonance imaging revealed tuberculomata and patchy infarcts. Despite antituberculous therapy, she progressively worsened. A cranial computed tomography scan done following the worsening revealed a massive middle-cerebral artery (MCA) infarct. Unfortunately, the patient died in spite of decompressive craniotomy. Malignant MCA territory infarct is a rare and potentially fatal complication of tuberculous meningitis. Back

Cancer is one of the leading causes of death worldwide. Gliomas are among the most devastating tumor types, and current clinical therapies are unsatisfactory. Recent reports revealed the importance of glioma-propagating cells in the malignancy of gliomas. These cells, also referred to as glioma... Read more

Cancer is one of the leading causes of death worldwide. Gliomas are among the most devastating tumor types, and current clinical therapies are unsatisfactory. Recent reports revealed the importance of glioma-propagating cells in the malignancy of gliomas. These cells, also referred to as glioma stem cells (GSCs), share similarities with neural stem cells (NSCs). The Hedgehog (Hh) signaling pathway controls tissue polarity, patterning maintenance, and maintenance of NSCs during embryonic development. Aberrant activation of the Hh pathway resulting from mutation and deregulation has recently been recognized to cause tumorigenesis in a wide variety of tissues, including gliomas and GSCs. In this review, we explore the role of the Hh signaling pathway in GSCs and its potential as a therapeutic strategy. Back

Aim: The aim was to validate a newly developed methodology of semi-automatic image analysis to analyze microglial morphology as marker for microglial activation in ionized calcium-binding adaptor protein-1 (IBA-1) stained brain sections. Methods: The novel method was compared to currently used... Read more

Aim: The aim was to validate a newly developed methodology of semi-automatic image analysis to analyze microglial morphology as marker for microglial activation in ionized calcium-binding adaptor protein-1 (IBA-1) stained brain sections. Methods: The novel method was compared to currently used analysis methods, visual characterization of activation stage and optical density measurement, in brain sections of young and aged rats that had undergone surgery or remained naοve. Results: The cell body to cell size ratio of microglia was strongly correlated to the visual characterization activation stage. In addition, we observed specific surgery and age-related changes in cell body size, size of the dendritic processes and cell body to cell size ratio. Conclusion: The novel analysis method provides a sensitive marker for microglial activation in the rat brain, which is quick and easy to perform and provides additional information about microglial morphology. Back

Toluene-induced leukoencephalopathy is a frequently seen medical condition worldwide; however the lack of specific clinical manifestations and laboratory tests makes it difficult to diagnose. Neuroimaging and medical history are often crucial to diagnosis of this disorder. In this report, a case... Read more

Toluene-induced leukoencephalopathy is a frequently seen medical condition worldwide; however the lack of specific clinical manifestations and laboratory tests makes it difficult to diagnose. Neuroimaging and medical history are often crucial to diagnosis of this disorder. In this report, a case is presented of a patient suffering from toluene-induced leukoencephalopathy with deteriorating cognition impairment and characteristic magnetic resonance imaging (MRI) findings, typified by a "sunflower-like" change in T2-weighted imaging. In addition, the pharmacokinetic properties of toluene are reviewed, as well as the clinical manifestations, typical MRI findings, neuropathology, possible mechanism, and treatment of toluene-induced leukoencephalopathy. Back

Neuromyelitis optica (NMO) is an autoimmune demyelinating disorder, predominantly characterized by severe optic neuritis, transverse myelitis and the high level of antibodies against aquaporin-4 (AQP4) or NMO-immunoglobulin G (IgG). Researches trying to correlate NMO with specific human leukocyte... Read more

Neuromyelitis optica (NMO) is an autoimmune demyelinating disorder, predominantly characterized by severe optic neuritis, transverse myelitis and the high level of antibodies against aquaporin-4 (AQP4) or NMO-immunoglobulin G (IgG). Researches trying to correlate NMO with specific human leukocyte antigen (HLA) alleles took place in a limited extend in the last few years. Nevertheless, it has become clear that HLAs play a crucial role in the genetic risk of NMO, in the understanding of its pathogenesis and the differential diagnosis mainly from multiple sclerosis (MS), and also from other demyelinating diseases. In this study, we retrieved all the available data in the MEDLINE concerning the distribution of HLA frequencies in NMO and NMO-spectrum diseases, in all available ethnic groups, and compared them with those of MS. The results suggest that, the well-established HLA-DRB1*15:01 allele, associated with MS, plays rather a protective role for NMO. HLA-DRB1*03 allele is highly frequent in the NMO-IgG positive Caucasian patients, while HLA-DPB1*05:01 is the predominant allele in Japanese patients. The HLA-genotype and anti-AQP4 presence are the common immunological components in cases of comorbidity of NMO and other autoimmune diseases. The authors aim to summarize in the critical review the results of these researches worldwide, create a workable table including all this information for an easier reading approach and highlight the importance of these results in therapeutic decision making, using the HLA profile as biomarker in patients' stratification. Back

Aim: The aim was to investigate the electro-physiological characteristics in disease progression of Guillain-Barre syndrome (GBS) and observe the effect of conduction block (CB) in classification and severity of the disease. Methods: Two hundred and ninety-four patients with GBS were divided into... Read more

Aim: The aim was to investigate the electro-physiological characteristics in disease progression of Guillain-Barre syndrome (GBS) and observe the effect of conduction block (CB) in classification and severity of the disease. Methods: Two hundred and ninety-four patients with GBS were divided into acute inflammatory demyelinating poly-neuropathy (AIDP) group, acute motor axonal neuropathy (AMAN) group and equivocal group according to their electro-physiological results and then reclassificated after electro-physiological review. All of the patients were followed for 6 months since their attacks. Results: Bad prognosis is more pronounced in AMAN group than in AIDP group (P<0.05). Most of the patients classificated as AIDP transformed into AMAN when CB occurred in the early phase of the disease. There is a positive relationship between CB in the early phase of the disease and severity of illness (P<0.05), but CB showed no correlation with prognosis of the patients (P > 0.05). Conclusion: CB in the early phase of GBS indicates the probability of AIDP transforming into AMAN; it suggests that patients with CB in the early phase of the disease might be in serious conditions in a certain extent. Back

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state coupled with a unique computed tomography or magnetic resonance imaging (MRI) appearance. Recognized in the setting of a number of complex conditions (preeclampsia/eclampsia, allogeneic bone marrow transplantation, organ... Read more

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state coupled with a unique computed tomography or magnetic resonance imaging (MRI) appearance. Recognized in the setting of a number of complex conditions (preeclampsia/eclampsia, allogeneic bone marrow transplantation, organ transplantation, autoimmune disease and high-dose chemotherapy) in the imaging, clinical and laboratory features of this toxic state are becoming better elucidated. We are presenting a case of PRES due to seronegative systemic lupus erythematosus, with MRI findings of diffuse vasogenic edema. Back

Aim: Immune challenge during early and late neonatal periods can induce robust alterations in physiological and behavioral functions, resulting in greater risk for the development of neuropsychiatric disorders, such as anxiety and depression, later in life. In addition, previous studies concluded... Read more

Aim: Immune challenge during early and late neonatal periods can induce robust alterations in physiological and behavioral functions, resulting in greater risk for the development of neuropsychiatric disorders, such as anxiety and depression, later in life. In addition, previous studies concluded that increasing age correlates with increased depression behaviors in humans and rodents. This study aimed to investigate for the first time whether immune challenge with a viral mimic, synthetic double-stranded ribonucleic acid (Poly I: C) during different neonatal periods can differently affect depression-related behaviors in adolescent and adult mice. Methods: Male C57BL/6 mice were treated with either saline or Poly I:C (1 mg/kg and 4 mg/kg) on postnatal days (PND) 3-5 (early neonatal phase) or PND 14-16 (late neonatal phase), and then subjected to behavioral tests, including tail suspension test and forced swimming test, during adolescence (PND 35 or 40) and adulthood (PND 85 or 90). Results: The results demonstrated that early neonatal immune activation increases depression-related behaviors in both adolescent and adult mice, but late neonatal immune activation only increases depression in adult mice. In other words, these findings indicated that the nature of the offspring's neuropathology can depend on the severity of the insult, the pup's age at the time of the insult, and offspring age at the time of behavioral testing. Conclusion: These findings suggest that dose and timing of neonatal insult and offspring age may be important factors for evaluating neuropsychiatric disorders in adults who experienced early life infection. Back

Aim: Japanese encephalitis (JE) is caused by a mosquito-borne flavivirus and demonstrates high mortality and serious sequelae. Imaging and cytological examinations are important for the diagnosis of JE. We performed this study to analyze the imaging and cytological characteristics of JE. Methods:... Read more

Aim: Japanese encephalitis (JE) is caused by a mosquito-borne flavivirus and demonstrates high mortality and serious sequelae. Imaging and cytological examinations are important for the diagnosis of JE. We performed this study to analyze the imaging and cytological characteristics of JE. Methods: This study enrolled 92 JE patients with 108 cerebral spinal fluid (CSF) samples. Diagnosis was based on clinical features and positive immunoglobulin M antibodies against JE virus, which were measured using enzyme-linked immunosorbent assay. All patients received detailed neurological examinations, relevant cerebrospinal fluid tests, and brain neuroimaging (computed tomography, magnetic resonance imaging, or both). Results: Prominent involvement in the hippocampus was observed in 10 patients on neuroimaging, in addition to classic involvement in the thalamus and basal ganglia. Lumbar puncture pressure was normal in 61 CSF samples. White cell count increased in 81.19% of CSF samples, 67.65% and 83.33% of CSF samples demonstrated normal chloride and glucose concentrations, respectively, and 82.52% of CSF samples demonstrated >0.4 g/L protein content. JE patients demonstrate mixed-cell reaction on cerebrospinal fluid cytology in the early phase, which subsequently mainly develop as mainly lymphocyte reaction or typical lymphocyte reaction. Conclusion: JE imaging is characterized by bilateral thalamic involvement, and the basal ganglia and hippocampus are also commonly affected. The mixed-cell reaction in JE lasts longer than in general viral encephalitis. This may facilitate the differential diagnosis of JE. Back

N-methyl-D-aspartate receptors (NMDARs) are mainly distributed in the central nervous system, and play important roles in the mechanisms of learning and memory. A newly discovered disease caused by autoantibody to NMDAR has been described, and is called anti-NMDAR encephalitis. Patients with this... Read more

N-methyl-D-aspartate receptors (NMDARs) are mainly distributed in the central nervous system, and play important roles in the mechanisms of learning and memory. A newly discovered disease caused by autoantibody to NMDAR has been described, and is called anti-NMDAR encephalitis. Patients with this disease often suffer from mental disorders, seizures and other encephalitis-like symptoms. Accumulated data suggests that the severity of the disease makes early diagnosis very important. Accurately detecting the autoantibody to NMDAR is considered to be the gist of diagnosis. Good prognosis is predicted in most patients, when treated properly. Immunotherapy is preferred in most cases. In China, this disease has been reported only for a few years, but sporadic case reports are also helpful for profiling. Back

Aim: The aim was to investigate the infectious conditions of Epstein-Barr virus (EBV) in patients with multiple sclerosis (MS). Methods: Cerebrospinal fluid (CSF) of 20 patients with MS and 20 with other neurological diseases (OND) were tested with indirect immunofluorescence for anti-EBV capsid... Read more

Aim: The aim was to investigate the infectious conditions of Epstein-Barr virus (EBV) in patients with multiple sclerosis (MS). Methods: Cerebrospinal fluid (CSF) of 20 patients with MS and 20 with other neurological diseases (OND) were tested with indirect immunofluorescence for anti-EBV capsid antigen (EBV-CA) immunoglobulin G (IgG), IgG affinity for anti-EBV-CA, anti-EBV-CA immunoglobulin M (IgM), anti-EBV early antigen (EBV-EA) IgG and anti-EBV nuclear antigen (EBNA) IgG. According to the pattern of antibodies in CSF, infection rates of acute, chronic, primary, recurrent, and past infections were analyzed in the two groups of patients. Results: There were no significant differences in anti-EBV-CA, anti-EBC-EA, and anti-EBNA antigen IgG in CSF between MS and OND patients (P > 0.05). The positive rate of low affinity for anti-EBV-CA IgG in MS patients was significantly higher than that for OND patients (75% vs. 40%, P < 0.05). Furthermore, significant differences in the positive rate of anti-EBV-CA IgM were found between MS and OND patients (70% vs. 25%, P<0.05). Of the MS patients, 75% were in an EBV acute infection state compared with 40% of OND patients (P < 0.05). Conclusion: Acute infection of EBV closely correlates with the occurrence of MS. Back